Giske Liv, Vøllestad Nina Køpke, Mengshoel Anne Marit, Jensen Jørgen, Knardahl Stein, Røe Cecilie
Department of Work-related Musculoskeletal Disorders, National Institute of Occupational Health, Oslo, Norway.
Eur J Pain. 2008 Apr;12(3):351-60. doi: 10.1016/j.ejpain.2007.07.007. Epub 2007 Sep 10.
The pathogenesis of widespread pain and fibromyalgia (FM) is unknown. Altered responses from the hypothalamus-pituitary-adrenal axis, sympathetic nervous system and muscular system have been suggested as being of importance. The present study was undertaken to determine: (i) whether the sympathoadrenal response to repetitive isometric contractions until exhaustion is altered in patients with FM, and (ii) whether sympathoadrenal responses are associated with muscle fatigue and pain during exercise. Nineteen women with FM, and 19 healthy women matched for age, smoking and self-reported physical activity, participated. Maximal voluntary contraction (MVC), repetitive isometric contractions (6s contraction and 4s resting phases) were performed with both quadriceps muscles at 30% of MVC until exhaustion. Muscle activity was recorded from the quadriceps muscles by surface electromyography (EMG). Plasma adrenalin (Adr), noradrenalin (NAdr) and cortisol were measured and perceived exertion and pain reported during exercise. Attenuated Adr responses (p<0.001) with normal plasma NAdr and cortisol (p>0.19) responses were found during exercise in the FM group compared with the control group. Significantly higher EMG amplitude (%EMG(max)) during the contraction phases (p=0.001) was found in the FM than in the control group. Perceived exertion and pain responses to exercise were higher in the FM group than in the controls (p<0.001), without relationship to the sympathoadrenal responses. In conclusion; the exercise was perceived as being more painful and strenuous in the FM group. Muscle performance was altered with increased muscle activity during the exercise. Women with FM showed an attenuated Adr response to repetitive isometric exercise.
广泛性疼痛和纤维肌痛（FM）的发病机制尚不清楚。下丘脑-垂体-肾上腺轴、交感神经系统和肌肉系统的反应改变被认为具有重要意义。本研究旨在确定：（i）FM患者对重复性等长收缩直至力竭的交感肾上腺反应是否改变，以及（ii）交感肾上腺反应是否与运动期间的肌肉疲劳和疼痛相关。19名患有FM的女性和19名年龄、吸烟情况及自我报告的身体活动相匹配的健康女性参与了研究。双侧股四头肌以最大自主收缩（MVC）的30%进行重复性等长收缩（6秒收缩和4秒休息阶段）直至力竭。通过表面肌电图（EMG）记录股四头肌的肌肉活动。测量血浆肾上腺素（Adr）、去甲肾上腺素（NAdr）和皮质醇，并记录运动期间的主观用力感觉和疼痛情况。与对照组相比，FM组在运动期间发现Adr反应减弱（p<0.001），而血浆NAdr和皮质醇反应正常（p>0.19）。FM组在收缩阶段的肌电图振幅（%EMG(max)）显著高于对照组（p=0.001）。FM组对运动的主观用力感觉和疼痛反应高于对照组（p<0.001），且与交感肾上腺反应无关。总之，FM组感觉运动更疼痛、更费力。运动期间肌肉活动增加，肌肉表现发生改变。患有FM的女性对重复性等长运动的Adr反应减弱。
